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1 Feb. 0, F. LIBERSON AUTOMATIC DISPLACEMENT SYRINGE s Fi ed July ill, 193 1,948,388. Sheets-Sheet l ØZZZZZZZZZZZZZZZZZZ kººsse, SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS}} ºzzzzzzzzzzºzzzzzzzZZZZZZZZZZZZZZZZZZZZZZ <<<<<<<<<<<<<<<<?<<<<<<<<<<<<<sssssssssssssssssssn?zzzzzzzzzzzzzzzzzzzzzzz, <<<<<<<<<<<<<<<<<<<<<<<<<<s?ssssssssssss}}? <<<<<<<<<<<<<<<<<<<<<<<<<<SSSSSSSSSSSSSSSSSSN SN?>>>>>>>>????azzzzzzzzzZzZ@@&&3&& <<<<<<<<<<<<<<<<<<ssssssssssssssssssssssssss} Øiji ºzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz& N SSSSSSSSSSSSSSSSSSSSSSSSSS`N SSSSSSSSSSSSSSSSSSSS}?????????????????????azzzzZZZZZZZZZZZZZZZZZZZZZ *<<<<<<<<<<<<<<<<<<<<SS N?~~~~<<<<<<<<<<<<<<SSSSSSSSSSSSSSSSSSN?SSSSSSSSSSSSS pºzzzzzzzzzzzz <<<<<<<<<<\ <S> zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz% - RY S SSSSS N SNS % s. l A. 1. N WITNESSES 777, NVENTOR ZZe/SO/7 ATTORNEY

2 Feb. 0, F. L. BERSON AUTOMATIC DISPLACEMENT SYRINGE Filed July ll, 193 \ A. S i %l 4. A.

3 Patented Feb. 0, , UNITED STATES This invention relates to automatic displace ne:nt Syringes and pairticularly to a Syringe for medical purposes for removing small quanti ties of fluid from different parts of the body and Substituting air or other gas therefor. An object of the invention is to provide an improved automatic displacement Syringe which is particularly adapted for removing liquid from the Spinal column or from the brain and Sub stituting air or gas therefor. Another object of the invention is to provide an automatic displacement Syringe for medical purposes Which When used to Withdraw fuid from a lumbal' puncture Will overcome the dan gers associated with sudden changes in intra Ci'ania and intra Spinal pressures during the pro cedure of Substitution of gas for the cerebro Spinal fluid for the purpose of encephalography. In the accompanying drawings, - Figure 1 is a longitudinal vertical sectional View through an automatic displacement Syringe disclosing an embodiment of the invention, the Same being shown ready for use. Figure is a view similar to Figure 1 but showing the plunger in an extreme outer posi tion. Figure 3 is a fragmentary Sectional view through Figure 1 on line 3-3. Figure 4 is a side view of the reversing rod disclosing certain features of the invention. Figure is a View Similar to Figure 4. but showing the rod and associated parts in a re verse position. Figure 6 is a WieW Sinaiar to Figure 1 but showing a modified construction wherein a Single piston. Or plunger is used but divided into two parts. Figure is a fragmentary View Similal' to one end of the structure shown in Figure but ill lustrating the position of the parts when the plunger has been moved outwardly for its full stroke. Figure 8 is a fragmentary Sectional view through Figure 6 on line 8-8. Figure 9 is a view similar to Figure 6 but showing a modified construction. Figure 10 is a view similar to the left-hand end of the structure shown in Figure 6 but with the plungers and associated parts in their outer positions. Figure 11 is a Side View on a reduced Scale of the structure showin in Figure i as the same Will appear when in use, the Syringe being shown in connection. With part of a Spinal column. Referring to the accompanying drawings by PATENT OFFICE 1948,388 AUTOMATIC DISPLACEMENT SYRINGE Frank Liberson, Brooklyn, N. Y. Application July 11, 193. Serial No. 61,96 9 Claims. (CI ) numerals, 1 indicates a needle of a desired kind which is adapted to be inserted through a de sired opening in the cranium or into the Spinal column as illustrated in Figure 11. This needle is frictionally connected to a hollow discharge 60 member, the same being preferably connected by friction, though other connections may be used without departing from the Spirit of the invention. The discharge member forms part of what 6 may be termed an adaptor 3, which adaptor is really an especially formed valve. A cylinder 4 is mounted on the casing of the adaptor 3 and held in place by adhesive, metal or other material 6. Arranged in the barrel 4 is an in- 0 ner barrel 7 which is secured to the casing in a similar manner as the barrel 4. These bar rels are concentric and are open at the outer end SC that there Will be a central chamber 8 and a circular or outer chamber 9. A piston or 7 plunger i0 is provided With a central plunger section 11 and an outer annular plunger section 1. These sections merge together into a knob 13. Whereby the plunger 10 may be moved in and out as desired. - As it will be hereinafter noted the plunger 10 when pulled out acts to draw in air to the outer chamber 9 and to draw fluid into the central Or inner chamber 8. Also, the parts are So pro portioned that the adaptor or valve 3 is reversed 8 as soon as the plunger 10 has been moved out to its extreme outer position and then moved in a very short distance toward its inner position. When the adaptor 3 is reversed and the plunger 10 is forced in Wardly the air in the outer cham- 90 ber will be forced through the outlet member and the fluid in the central chamber Will be discharged out through the fluid discharge men ber 14, and guided by a suitable flexible pipe 1 to a desired point or to a suitable container. 9 It will be noted that from the outer chamber - 9 a. single passageway 16 leads, while from the inner chamber 8 two passageways, namely, pas sageways 17 and 18, lead. A valve key 19 is rotatably mounted in the casing and is pro- 100 vided with passageways 0,, and 3. When the device is in the position shown in Figures 1 and 11, the first outward movement of the plunger 10 will draw in fluid through the outlet through passageways and 16 into 10 chamber 9. At the same time air Will be drawn in from a Suitable container or filter, or some other Supply, through the flexible pipe 4 through the hollow projection and through passageways 0 and 18 into the central chamber

4 10 0 S 3 SO 6. 1,948, The sucking action of the plunger Will con tinue until the parts have been moved to their extreme outer positions. As soon as moved to the outer position the direction of movement of the plunger is reversed, and, as hereinafter fully described, will rotate the key 19 so that it will assume the position shown in Figure, Where upon the air in the central chamber 8 Would be forced out the passageway 17 through pas SageWay 1, through the outlet member, and thence into the spinal column to take the place Of the fuid that has been Withdrawn therefron. At the same time that the air from the chamber 8 is forced into the spinal column the fluid in chamber 9 is forced out through the passage ways 16 and 3 into the hollow projection 6, and from thence through the pipe 1 to a con tainer or suitable device for the reception of the fluid. As the plunger completes its full inward move ment the bar 9 and associated parts, as here inafter fully described, Will function and callse a reversal of the key 19 so that it will reassune the position shown in Figure 1, and at the Sec ond outward movement of the plunger, Will again draw in the fluid into the outer chamber 9 and air into the inner chamber 8. This action is repeated as often as desired to secure the amount of fluid necessary. Heretofore, it has been customary to draw Out Somewhere from to 10 c.c. upon each ac tuation of the Syringe and then later inject the same amount of air into the Spinal canal. This is more or less objectionable as it first reduces the pressure appreciably in the spinal canal and then increases the pressure. It will thus be seen that by removing large quantities of the fluid from the Spinal canal and then Substituting thereafter large quantities of air Will necessi tate an appreciable time interval between the removal of the fuid and the Supply Of air. This interval is the time necessary to Withdraw the fluid, eject the fluid from the Syringe, draw in air and then inject the air into the Spinal canal. During this interval the brain and Spinal cord are trying to adjust themselves to dimin ished pressure but by the time they have ad justed themselves to this diminished pressure, they have to re-adjust themselves again to an increased pressure by reason of the injection of the air. This, therefore, makes a constant back-and-forth or see-saw movement in the Spinal canal and brain as the increased and de creased pressures take place, the Same lasting by the method heretofore used from one to three minutes. This causes objectionable and Severe reaction in the patient in the Way of head aches and other reactions. In order to obviate the major part of the interval of diminution of pressure and the See-SaW movement of the pres Sure in the intraspinal and intracranial cav ities, the present invention enables the operator to save at least one-half of the time of the total procedure, and thus save the patient a major part of the see-saw movement of the pressures, and it avoids removing large quantities of fluid at one time. In the Syringe shown in Figure 1 very Small quantities of fluid may be removed on each actu ation of the device and the device, of course, may be actuated as many times as desired to secure the full quantity necessalry for a given pur pose, as, for instance, for a test or to relieve pressure produced by an accident on the spinal column or produced by Some other cause. The Syringe is adapted to draw one, two or more c. c's. On each outward movement and inject Cil each inward movement the same Volume of air, thus destroying the diminution of pressure al most as soon as it has been created. By the automatic shifting of the key 19 the plunger 10 may be moved back and forth regularly and comparatively fast without injury to the patient so that in the reduced time interval or 10 c. c's. could be removed but at no time could there be more removed than a very Small quan tity, as, for instance, c. c's. As illustrated in Figures 1 to inclusive, it will be seen that the key 19 is held against movement in one direction by the screw 7 aind in the opposite direction by the screw 8 acting in connection with a reversing bar 9 and Cer tain associated parts. The reversing bar 9 is connected by screw to a clamp 3 which through the use of a screw 3 is clamped firmly to the plunger 10 so that the bar 9 will re ciprocate with the plunger 10. The bar 9, as shown in Figures 4 and, is provided with an enlargement 33 which has a slot 34 in which the reduced extension 3 of key 19 fits. This extension is provided With a pin 36 adapted to be struck by the respective projections 37 and 38 as the rod 9 functions. As shown in Figure 1, the extension 38 is struck and caused to swing over the pin 36 and the key 19 to the position illustrated in Figure l. When the plunger moves outwardly for its full distance on the last part of its travel, the lug 37 strikes the pin 36 and swings this pin and the key 19 to the position shown in Figure, whereupon the ports in the key 19 are reversed. If it should be desired at any time to remove the key 19, the screw could be removed and screw 8 also, as well as screw 7. The key 19 could then be slipped out of the casing and replaced whenever desired. However, immedi ately before the plunger 10 moves to its extreme outer position, the rod 9 causes the abutment or lug 37 to rotate the key 19 to the position shown in Figure, and immediately before the plunger 10 has moved to its extreme inner po sition the abutment 39 begins to function and functions to reverse the ports of the key 19. This action is automatic and does not require any particular attention by the person using the device. It will thus be seen that as the plunge; 10 is moved back and forth slowly the device functions to draw in air and fluid on the out Ward stroke and force the air and fluid out wardly on the inward stroke, the fluid passing to a desired container and the air passing back through the needle 1 into the place from which the fluid has been drawn. By this construc tion and arrangement there is no time lost in shifting valves and providing a four-cycle action instead of a two-cycle action. In Figures 6 and 7 a slightly modified struc ture is shown to that illustrated in Figures to inclusive. In these two figures modified Struc tures will be given separate numbers and the - remaining structures Will use the numbers ShOWn. in Figures 1 and. As shown in Figure 6, the casing is pro vided with a division plate 39 So that the plung er must be provided With a slot 41 for a,c- commodating this division plate. As illustrated in Figure 3 a division plate 39 extends from One Side to the other of the cylinder 4, and, there fore, the sections 43 and 44 of the piston act as separate plungers SO that the chambers i 3 & aiv ili v.

5 0 3 and 46 will act as the chambers 8 and 9. It Will be understood that this form of the in vention, as well as the form shown in Figure 1, may be made from any desired material or a combination of material without departing from the spirit of the invention. In Figure 6 the parts are shown ready for an OutWard movement for drawing in a quantity of fluid. In Figure 7 the parts are shown in their reversed positions so that when the piston has moved back to its inner position air Will be forced into the spinal column, while the fluid previously drawn in Will be forced into the con tainer. In Figures 9 and 10 a further modified form of the invention is shown and additional nun bers will be given for the modified Structure. The casing in this form of the invention is provided with internally threaded bosses 4 and 48 for receiving the threaded extensions 49 and 0 of the respective cylinders 1 and. These cylinders are provided With plungers 3 and 4 which are connected to a Suitable clamp, said clamp in turn being secured by a screw to the rod 9. The plunger's 3 and 4 are ready to move outwardly and draw in a supply of liq uid into the cylinder and a supply of air into the cylinder 1. Figure 10 shows the same structure as illus trated in Figure 9 but with the plungers in their outer positions and starting inwardly. As the plungers move inwardly the air previously drawn into chamber 1 would be forced out through the discharge member into the spinal column and the liquid from the cylinder would be dis charged through the pipe 1 to the container provided to receive the Sane. It Will be seen that in all forms of the inven tion the same rod 9 is used and also the same adaptor 3 for providing a switching of the fluid and air upon the return movement of the respec tive plungers. Also, in all forms of the inven tion the parts are automatic throughoult and after it has once been placed in position, as illustrated in Figure 11, it is only necessary to pull the plunger outwardly and then force the Same in Wardly a desired number of times to Se cure a desired volume of fluid and replace the fluid with an equivalent in air. I claim:- 1. An automatic displacement Syringe includ ing a pair of chambers, means in the chambers acting as plungers, a valve connected to said chambers, said valve having a key provided with four passageways and a casing having a center and two side discharge members and three pas Sageways, two of said passageways continually registering with one of said chambers and the other of Said passageways registering with the remaining chamber, said key being positioned So that the passageways therein when in one position Will register with two of said passage WayS, Said central discharge member and one of Said side discharge members, and when in a Second position the other two passageways in the key will register with said central discharge member and the other of said side discharge members, and means for automatically rotating Said key as said plungers move from one extreme position to the other, all of said passageways being So arranged that when said plungers are moved to their extreme outer positions matter Will be drawn into one of said chambers from the central discharge member and matter will 3 be drawn into the other of said chambers 1,948,888 through one of Said side discharge members, and when Said plungers are moved to an inner posi tion the key will be changed to permit the matter previously drawn in to be discharged through the central discharge member and tihe other of Said Side discharge members.. A displacement Syringe comprising means forming two chainbei's, a plunger arranged in each chamber, Said plungers functioning as one, a valve connected to said chambers and means for shifting said valve automatically as the plungers move to an extreme outer position and an extreme inner position, Said waive being pro vided with ports to draw in a Supply of fluid from a source to one of said chambers as the plunger moves outwardly and at the same time draw in air to the other of said chambers, Said valve being also constructed with ports So that when said plungers are moved inwardly the fluid drawn in will be discharged out of a different passageway and the air drawn in will be simuli taneously discharged out through the fluid port so as to furnish a displacing agent for the With drawn fluid. 3. A displacement syringe of the character de scribed including a pair of simultaneously op erating pump structures, each of Said pump structures having a pair of passageways acting respectively as an inlet and an outlet, a rotatable valve constructed with ports so positioned that when said pump structure functions the fluid drawn in will be discharged out of a different passageway, and the air drawn in will be simul taneously discharged out through the passage way through which the fluid has been drawn in so as to furnish a displacement agent for the withdrawn fiuid, and means operated by part of the pump structures for automaticaily actu ating said valve for changing the ports thereof at the respective extreme positions of the pump structures. 4. A displacement syringe include means pre senting a pair of pump Structures, Said pump structures operating simultaneously, a valve connected to said pump structures, said valve having a casing provided with a central outlet member and two side outlet members, Said cas ing also being provided with three ports lead ing from the respective chambers of the two pump structures, two of Said ports leading from Gne chamber, a waive key provided With four ports arranged so that two will connect the central outlet and one side outlet at One time with the respective chambers of Said pump structures and the other two at a second Setting to Corinact the respective pump structures With the central outlet and the other side outlet, said means connected to the pump structures for actuating said key at the beginning of each stroke.. A displacement, Syringe for medical pur poses adaped to l'enhove Spinal fluid from the spinai canal and substitute air comprising two cylindrical nembers open at both ends, a valve having a Casing, said cylindrical member's hav ing one end embedded in said casing, Said cylin drical members being arranged concentrically, a plunger having an inner tubular section fitting Within the inner cylinder, an outer annular sec tion fitting within the citer cylinder and exter iorly of the inner cylinder, and means actuated by said plunger for shifting the ports of said wave. So that C the out Ward Stroke fluid from the spinal canal will be drawn into one of Said cylinders and air will be drawn into the other 3. 8C) i O O 1. s i 3.

6 , and upon the inward stroke the fluid drawn in will be discharged at a given point and the air drawn in will be forced into the Spinal canal. 6. A displacement syringe for medical pur poses adapted to remove spinal fluid from the spinal canal and substitute air therefor compris ing a cylinder, a valve connected to one end of said cylinder, said valve having a division plate extending therefrom merging into Said cylinder whereby said cylinder for the length of Said division plate is divided into two chambers, a plunger formed with a bifurcated structure of a shape to fit into said chambers and means connected with said plunger for automatically shifting the ports in said valve whereby when said plunger is moved outwardly spinal fluid Will be di'awn into one of Said chambers and air into the other and When the plunger is moved inwardly the drawn-in spinal fluid will be discharged at a given point, and the drawn in air will be forced into the Spinal canal, Said air and fluid being of the Sane Volume. 7. A displacement Syringe for medical pur poses adapted to remove spinal fluid from the spinal canal and Substitute air therefor com prising a pair of cylinders, a single valve con nected to both of Said cylinders, a plunger ar ranged in each cylinder, a clamp for connecting Said plungers So they will Work in unison, and means actuated by Said clamp for causing said Valve to shift its ports as Said plungers move to their respective extreme positions whereby when Said plungers move OutWardly Spinal fluid Will be drawn in one of said cylindel's and air of the same volume into the other cylinder and when said plungers are forced in Wardly said air Will be forced into the Spinal canal and the fluid Will be forced out through a discharge point. 8. A displacement Syringe of the character described including a pair of Simultaneously operating pump structures constructed so that each pump structure Will draw in the same volume of matter on the intake stroke each of the pump structures having a pair of passage ways respectively acting as inlet and outlet openings, a valve having four ports, there be ing one port for each of said passageways, Said ports being so positioned that when said pump structures function, One pump structure Will draw in fluid through one of said passageways and one of said ports, while another pump Structure Will diaw in air through a Second passageway and a second port, Said pump Struc tures when functioning on the return Stroke acting to force the air previously dra Win in out through a third passageway and a third port and into the space from which the fluid has been drawn so as to furnish a displacement agent for the Withdrawn fluid and Simultane ously discharge the fluid previously drawn in out through a fourth passageway and a fourth port, and means operated by part of the pump structures for automatically changing the ports of the valve at the respective extreme positions of the pump structures. 9. A displacement Syringe for medical pur poses including means for Substituting air in the Spinal canal for the Spinal fluid, including a pair of reciprocating pumps each having an inlet and an outlet passageway and a rotatable Valve having a port for each of Said passageways functioning to cause the Spinal fluid to flow out of the Spinal canal through one of Said ports and One of Said passageways into one of the pumps On the OutWard stroke of Said pump, and an equal volume of air to flow into the Spinal canal through a Second passageway and a Second port fron the other pump on the return Stroke of Said pumps, the first mentioned pump discharging the Spinal fluid on said return. Stroke through a third passageway and a third port. FRANK LIBERSON O issu) 7